Common carotid artery bifurcation: preliminary results of CT angiography and color-coded duplex sonography compared with digital subtraction angiography

The purpose of this study was to compare the abilities of color-coded duplex sonography, CT angiography, and selective digital subtraction angiography to reveal disease requiring surgery in patients with occlusive disease of the carotid bifurcation. Fifty-six carotid arteries in 28 patients who had...

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Bibliographic Details
Published in:	American journal of roentgenology (1976) Vol. 168; no. 2; pp. 361 - 365
Main Authors:	Link, J, Brossmann, J, Penselin, V, Gluer, CC, Heller, M
Format:	Journal Article
Language:	English
Published:	Leesburg, VA Am Roentgen Ray Soc 01-02-1997 American Roentgen Ray Society
Subjects:	Angiography, Digital Subtraction Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cardiovascular system Carotid Artery, Common - diagnostic imaging Carotid Stenosis - diagnostic imaging Carotid Stenosis - surgery Cerebral Angiography Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Female Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Predictive Value of Tests Prospective Studies Sensitivity and Specificity Tomography, X-Ray Computed Ultrasonic investigative techniques Ultrasonography, Doppler, Color Sonography Human Nervous system diseases Radiodiagnosis Radiologic investigation Stenosis Cardiovascular disease Digital image Cerebral disorder Arterial disease Vascular disease Common carotid Color echography Central nervous system disease Medical imagery Computerized axial tomography Arteriography Diagnosis Cerebrovascular disease Comparative study
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Summary:	The purpose of this study was to compare the abilities of color-coded duplex sonography, CT angiography, and selective digital subtraction angiography to reveal disease requiring surgery in patients with occlusive disease of the carotid bifurcation. Fifty-six carotid arteries in 28 patients who had 48 carotid stenoses and symptomatic cerebrovascular disease were prospectively studied by selective digital subtraction angiography, color-coded duplex sonography, and CT angiography. CT data were displayed in maximum intensity projection. The degree of stenoses revealed were graded as mild, moderate, severe, and occluded according to North American Symptomatic Carotid Endarterectomy Trial criteria. The results of CT angiography and color-coded duplex sonography were correlated with the gold standard of digital subtraction angiography. Grading of stenoses on CT angiography agreed with grading of stenoses on digital subtraction angiography in 89% of cases. All high-grade stenoses and occlusions revealed on CT angiography were correctly interpreted by all observers. For stenoses revealed by color-coded duplex sonography and digital subtraction angiography, observers' agreement was 75%. Two severe stenoses were incorrectly graded as occluded by the interpreter of the color-coded duplex sonograms. Also, one occluded carotid artery was misdiagnosed as moderate stenosis. Our results indicate that CT angiography is superior to color-coded duplex sonography for evaluating carotid disease and determining disease requiring surgery. CT angiography warrants further investigation in a larger group of patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0361-803X 1546-3141
DOI:	10.2214/ajr.168.2.9016207